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A G Papatsoris

Publications and source records attributed to A G Papatsoris.

12 recordsLinked to original sources
PubMed2006

Tension-free vaginal tape for the treatment of stress urinary incontinence in geriatric patients.

OBJECTIVE: To evaluate the safety and efficacy of tension-free vaginal tape (TVT) for the treatment of stress urinary incontinence (SUI) in geriatric patients. PATIENTS AND METHODS: Fifty-one women, aged 65-80 (mean 72.3) years, underwent a TVT procedure for genuine SUI from 2001 to 2004. A urodynamic test together with uroflowmetry were performed. The patients' SUI bother score was assessed using a visual analog scale (VAS). RESULTS: The mean operative time was 25 (range 14-29) min and mean hospitalization time was 1.2 (range 1-2) days. Bladder perforation occurred in 3 cases (5.8%) and was managed conservatively. Pre- and postoperative maximum flow rate were not significantly different (p > 0.05). The patients' SUI bother score estimated by the VAS was statistically significantly improved (p < 0.0001). After a mean follow-up of 35.6 (range 14-60) months, 49 patients (96%) had no SUI, while 2 patients (3.9%) had persistent SUI. Also, during the follow-up 5 patients (9.8%) were diagnosed with de novo urgency due to detrusor overactivity and 1 patient (1.9%) had persistent dysuria that was resolved with urethrolysis. CONCLUSIONS: SUI in elderly women can be safely treated with the TVT procedure in the vast majority of the patients. However, bladder perforation during surgery and de novo urgency postoperatively should be taken into account.

Aged↗
PubMed2006

Can prostate biopsies affect erectile function?

The impact of transrectal ultrasound (TRUS)-guided prostate biopsies on erectile function was prospectively studied. Forty-six men (median age: 67.51 years) who underwent TRUS-guided prostate biopsies completed the International Index of Erectile Function (IIEF)-5 questionnaire at the day of the biopsy, 1 and 3 months later. Erectile dysfunction (ED) severity was classified into five categories. Concomitant ED-related systemic diseases and/or medications that could affect erectile function were also recorded. The paired t-test was used for statistical analysis. The median IIEF-5 score was 15.91 prior to biopsies, while 1 and 3 months after, the median IIEF-5 score was 14.33 and 14.81 respectively (P > 0.05). Prior to prostate biopsies, ED was reported by 38 patients (82.60%): mild ED in 39.13%, mild to moderate in 19.56%, moderate in 15.21% and severe ED in 8.69%. Concomitant ED-related systemic diseases and/or medications were recorded in 28 patients (60.86%). One month after, ED was revealed in 42 patients (91.30%): mild ED in 26.08%, mild to moderate in 30.43%, moderate in 19.56%, and severe ED in 15.21%. Three months post-biopsy, ED was reported by 41 patients (89.13): mild ED in 21.73%, mild to moderate in 28.26%, moderate in 21.73%, and severe ED in 17.39%. Overall, three and two patients (6.52% and 4.34%) had prostate biopsy attributed ED (i.e. without concomitant ED-related disease or medication) 1 and 3 months after prostate biopsies. TRUS-guided prostate biopsies did not induce ED in a statistically significant manner. Evaluating potency at referral for TRUS-guided prostate biopsies is advisable.

Aged↗
PubMed2005

Management of nocturnal enuresis in Greek children.

Our experiences of managing nocturnal enuresis in Greek children at our Outpatient Clinics of Pediatric Urology are described. Between March 2001 and October 2003, 142 children with primary nocturnal enuresis (93 boys and 49 girls), aged 7-18 years old (mean: 9.0+/-0.5) were included in this prospective study. Initially, behavioral conditioning therapy, using a body-worn urinary alarm, was instructed in all cases. If no improvement was recorded, 40 microg of intranasal desmopressin was administered, initially for three months. If urodynamic studies demonstrated pure detrusor instability, anticholinergics (5 mg oxybutinine or 2 mg tolterodine) were given instead. Combination medication (desmopressin and anticholinergics) was administered for coexisting diurnal enuresis, which was present in 8 children. Among the 142 children the overall response rate was 51.41%. Successful response was recorded in 16 children practicing conditioning behavioral therapy, in 47 receiving desmopressin (with or without anticholinergics), and in 10 children receiving only anticholinergics. During the follow-up period (mean: 6.2 months), no serious side effect was recorded. The use of desmopressin, and anticholinergics in specific subgroups, was found to be effective and safe for the management of nocturnal enuresis in children.

Administration, Intranasal↗
PubMed2005

Novel biological agents for the treatment of hormone-refractory prostate cancer (HRPC).

Hormone-refractory prostate cancer (HRPC) is an inevitable evolution of prostate carcinogenesis, through which the normal dependence on hormones for growth and survival is bypassed. Although advances in terms of symptoms palliation and quality of life improvement have been addressed with current treatment options, innovative approaches are needed to improve survival rates. A thorough understanding of HRPC-associated molecular pathways and mechanisms of resistance are a prerequisite for novel potential therapeutic interventions. Preclinical and early clinical studies are ongoing to evaluate new therapies that target specific molecular entities. Agents under development include growth factor receptor inhibitors, small molecules targeting signal transduction pathways, apoptosis and cell-cycle regulators, angiogenesis and metastasis inhibitors, differentiation agents, telomerase inactivators, and epigenetic therapeutics. Incorporation of these agents into existing treatment regimens will guide us in the development of a multidisciplinary treatment strategy of HRPC. This article critically reviews published data on new biological agents that are being tested in HRPC clinical trials, highlights ongoing research and considers the future perspectives of this new class of agents.

Angiogenesis Inhibitors↗
PubMed2004

Prevention of retrograde calculus migration with the Stone Cone.

Retrograde calculus migration during ureteroscopic lithotripsy remains a problem in 5-40% of cases. We assessed the safety and efficacy of the Stone Cone device, in comparison with the standard flat wire basket. A total of 56 consecutive patients with ureteral calculi, suitable for ureteroscopic extraction and/or lithotripsy, where included in this prospective study. Patients were randomly allocated into two groups. In group A (30 patients), we used the Stone Cone, while in group B (26 patients) we used the standard flat wire basket. The Stone Cone was placed through a cystoscope under fluoroscopic guidance, or when necessary under direct ureteroscopic control. Whenever necessary, intracorporeal electrohydraulic lithotripsy took place in both groups. Statistical significance was assessed by the paired t-test. The mean operative time was 48.5 min in group A, and 42.4 min in group B. Intact calculus extraction was possible in 16.6% in group A, and in 7.6% in group B (P < 0.01). Retrograde stone migration was revealed in 23% in group B only (P < 0.001). Also, residual fragments > 3 mm were recorded in 30.7% in group B only (P < 0.001). None of the patients in group A required auxiliary procedures, in contrary to 23% in group B (P < 0.001). No major complications were recorded in group A, while in group B a case of major ureteral mucosal abrasion was recorded. The Stone Cone is safe and efficient in preventing retrograde stone migration and in minimizing residual fragments during ureteroscopic lithotripsy in comparison with the flat wire basket.

Adult↗
PubMed2004

Adjuvant intravesical mitoxantrone versus recombinant interferon-alpha after transurethral resection of superficial bladder cancer: a randomized prospective study.

OBJECTIVE: To determine the efficacy and safety of two different doses of intravesical mitoxantrone and of recombinant interferon-alpha (IFNalpha-2b), instilled after transurethral resection (TUR) of superficial transitional cell carcinoma (TCC) of the bladder. MATERIAL AND METHODS: 208 patients (mean age 62.05 years) with primary or recurrent superficial (TaG1, T1G1, T1G2) bladder cancer were randomly allocated into four groups, after TUR of all visible tumors. Group A (45 patients) received no further therapy; group B (56 patients) received 10 mg of mitoxantrone (6 weekly and 20 fortnightly instillations), group C (54 patients) 20 mg of mitoxantrone (3 fortnightly and 10 monthly instillations) and group D (53 patients) received 100 MU of IFNalpha-2b (8 weekly, 8 fortnightly and 6 monthly instillations). RESULTS: During the follow-up (mean 21.09 months), 29 (64.44%) patients in group A had recurrence, compared with 19 (33.92%) in group B, 17 (31.48%) in group C and 15 (28.3%) patients in group D (p < 0.005). Furthermore, the differences in simple recurrence rates were statistically more significant (p < 0.05), when group A was compared with the three other groups in the terms of T1G2, recurrent and multiple neoplasms. Twenty-nine patients (10, 7, 8, and 4 in groups A-D) experienced tumor progression, and the differences between the four groups were not statistically significant (p > 0.05). The mean recurrence time was 9.03 months in group A, 13.74 in group B, 14.24 in group C and 17.4 months in group D (p < 0.001), and the recurrence rate per 100 patient-months was 4.39, 1.57, 1.48 and 1.06, respectively (p < 0.05). Toxicity (grade 1-3) was recorded in 23.21% in group B, in 31.48% in group C and in 9.43% in group D (p < 0.01). CONCLUSION: The two doses of mitoxantrone resulted in similar efficacy for the prevention of superficial bladder cancer recurrences, with the dose of 10 mg of mitoxantrone being related to fewer side effects. In comparison with mitoxantrone, the adjuvant intravesical immunotherapy with 100 MU of IFNalpha-2b showed a better combination of efficacy and safety.

Administration, Intravesical↗
PubMed2001

Molecular 'palpation' of BPH: a tale of MAPK signalling?

Benign prostatic hyperplasia (BPH) is a very common cause of hospitalization and surgery is currently the most effective therapy. MAP kinases (MAPKs) are a group of protein kinases with an important function in integrating physiological and pathological stimuli that might impact on cellular growth, differentiation and programmed cell death (apoptosis). Certain components of the MAPK signal-transduction pathways are involved in stimulus-specific fine-tuning of the activities mediated by the various MAPK families. As homeostasis is impaired in the hyperplastic prostate, aberrant coordination of the MAPK cascades might be implicated in a proliferative-apoptotic imbalance. Here, we hypothesize that the pathogenesis of BPH might be facilitated by functional anomalies in the MAPK circuitry and postulate that pharmacological 'rewiring' of MAPK pathways offers a potentially exciting new avenue for improved therapeutic control of clinical BPH.

Animals↗
PubMed2001

Prostate cancer: horizons in the development of novel anti-cancer strategies.

Prostate cancer is the most common cause of non-cutaneous cancer in men and a leading lethal malignancy with increasing incidence worldwide. Inevitably, all patients will develop androgen-independent disease, which remains the main obstacle to improving survival. Unfortunately, existing first and second line hormonal treatment are condemned to extent survival for only a few years. These sobering data have forced researchers to start exploring in depth the molecular mechanisms implicated in the emergence of androgen independence and of prostate cancer invasion. In this vein, epoch-making discoveries in molecular oncology along with rapid expansion of our knowledge concerning the processes that govern differentiation, apoptosis, immune surveillance, angiogenesis, metastasis, cell cycle and signal transduction control, have unveiled a plethora of specific targets for prostate cancer gene therapy, immunotherapy and anti-invasion therapy, along with a variety of small-molecule compounds which inhibit or stimulate these pathways. These new anti-cancer approaches are in various stages of clinical development, providing exciting perspectives for the future of prostate cancer cure and enriching the current anti-cancer drug quiver with a new spectrum of therapeutic agents. The present review, through extensive literature cross-examination, discusses several novel anti-prostate cancer strategies, emphasizing on approaches that potentially may extend end-stage patient's survival.

Angiogenesis Inhibitors↗